UPDATE 3/29

A few links, a few comments about those links, and then a link dump.

Current trajectory of Covid-19.  I’ll update the curve fit as often as I’m able to.

Coronavirus Could be Chimera of Two Different Viruses, Genome Analysis Suggests.

In December 2019, 27 of the first 41 people hospitalised (66 percent) passed through a market located in the heart of Wuhan city in Hubei province. But, according to a study conducted at Wuhan Hospital, the very first human case identified did not frequent this market.

Instead, a molecular dating estimate based on the SARS-CoV-2 genomic sequences indicates an origin in November. This raises questions about the link between this COVID-19 epidemic and wildlife.

[ … ]

On 7 February, 2020, we learned that a virus even closer to SARS-CoV-2 had been discovered in pangolin. With 99 percent of genomic concordance reported, this suggested a more likely reservoir than bats.

However, a recent study under review shows that the genome of the coronavirus isolated from the Malaysian pangolin (Manis javanica) is less similar to SARS-Cov-2, with only 90 percent of genomic concordance. This would indicate that the virus isolated in the pangolin is not responsible for the COVID-19 epidemic currently raging.

[ … ]

… these genomic comparisons suggest that the SARS-Cov-2 virus is the result of a recombination between two different viruses, one close to RaTG13 and the other closer to the pangolin virus. In other words, it is a chimera between two pre-existing viruses.

This recombination mechanism had already been described in coronaviruses, in particular to explain the origin of SARS-CoV. It is important to know that recombination results in a new virus potentially capable of infecting a new host species.

For recombination to occur, the two divergent viruses must have infected the same organism simultaneously.

Two questions remain unanswered: in which organism did this recombination occur? (a bat, a pangolin or another species?) And above all, under what conditions did this recombination take place?

That’s what I want to know.  And I’m still waiting.  I will wait patiently until something believable comes along.  A wet market in China is so far unconvincing to me.

Covid-19 transmission hypothesis.

It’s being spread in the medical environment — specifically, in the hospitals — not, in the main, on the beach or in the bar.

When Singapore and South Korea figured out that if as a medical provider you wash your damn hands before and after, without exception, every potential contact with an infected person or surface even if you didn’t have a mask on for 30 minutes during casual conversations with others (e.g. neither of you is hacking) transmission to and between their medical providers stopped.

Note — even if you didn’t have a mask on and were not social distancing in the work environment, which of course is impossible if you’re working with others in a hospital, you didn’t get infected.

And guess what immediately happened after that?  Their national case rate stabilized and fell.

The hypothesis that fits the facts is that a material part of transmission is actually happening in the hospital with the medical providers spreading it through the community both directly and indirectly.

[ … ]

This also correlates exactly with the explosive spread in nursing homes where many residents are incontinent.

I don’t know enough to confirm or deny this hypothesis.  I do know that the medical community recommends masks, and I sent my daughter to work with an N95 mask one night.  The hospital management objected and stated that she could only wear hospital issued masks.  She said, “Okay, give me one.”  They said, “Oh, we’re all out so you can’t have one.”

Can Lysol or Clorox kill the Coronavirus?

Lung damage seen in recently asymptomatic Coronavirus patient.

New treatment in Italy, ventilators combined with laying patients on their stomach.

China supplied faulty Coronavirus test kits.  Who’d a thunk it?  There’s a reason that most manufacturers of quality machines don’t rely on parts from China (and few rely on parts from anywhere in the far east).  They’ve never learned to handle and abide by QA requirements.  If you doubt this, ask why the NRC doesn’t allow parts made in China to be installed in American nuclear power plants?

CPAP machines as ventilators.  It’s complicated.  See especially the comments section for details from the doctors.

UPDATE 3/23

Breitbart.

Yesterday, I reported the existence of three studies, all claiming that chloroquine phosphate had proved effective in treating the COVID-19.

This has since been confirmed by a more recent open-label non-randomised clinical trial in France by Didier Raoult​ M.D/Ph.D et al, completed just days ago. The sample was small but the results were convincing.

As the summary reports:

100% of patients that received a combination of HCQ and Azithromycin tested negative and were virologically cured within 6 days of treatment.

In addition, recent guidelines from South Korea and China report that hydroxychloroquine and chloroquine are effective antiviral therapeutic treatments for novel coronavirus.

But the story gets more extraordinary still. It turns out that the Centers for Disease Control and Prevention (CDC) has known since at least 2005 that chloroquine is effective against coronaviruses.

In 2005, Martin J Vincent et al published a study in Virology Journal titled ‘Chloroquine is a potent inhibitor of SARS coronavirus infection and spread.’

[ … ]

It ought to be no surprise that chloroquine is effective against both SARS and COVID-19. After all, they are both coronaviruses and COVID-19 has often been described in medical and research sources as SARS-2.

Chloroquine works by enabling the body’s cells better to absorb zinc, which is key in preventing viral RNA transcription – and disrupting the often fatal cytokine storm.

As at least one person has noticed, the implications of this are enormous. If the medical establishment – including CDC – has been aware of the efficacy of chloroquine in treating coronavirus for at least 14 years, why has it not been mass produced and made available sooner?

Here, you might have imagined, is the dream solution: a stop gap treatment for coronavirus which could save many lives and obviate the need for this global lockdown which is destroying our economies.

Why isn’t the solution being shouted from the rooftops?

One possibility, as I suggested yesterday, is that there is no money in it for Big Pharma. Chloroquine is a generic drug. That’s why Big Pharma’s lobbyists have worked hard to persuade governments that there can be no acceptable solution till a patented vaccine is brought on to the market.

Even if there is nothing nefarious about this (e.g., the Covid-19 virus is too different to surmise the applicability of a specific drug until it has been tested), the optics are very, very bad for big Pharma.  Very bad indeed.  It took French researchers to push hydroxychloroquine as a therapeutic.  Why?  Why not American doctors?

As I said before, the CDC and the NIH bear a huge amount of responsibility for all of this.  Dr. Anthony Fauci should be canned as soon as possible and replaced with someone competent to do the job.  America was caught too unprepared for my tastes.

On another front, based on one source, I can report that a local hospital has taken the following position concerning hydroxychloroquine.  “It will only be administered by infectious disease doctors, and then, only as a very last resort, i.e., as “rescue adjunctive therapy” and only after development of ARDS.”

But what if the patient is too ill to recover at that point?  Why wait this late?

An updated graph is shown below.  The doubling time is now at 2.32 days.

UPDATE 3/22

Ingenuity.  Need more of that these days.  Necessity is the mother of invention.

Obama can be held responsible for the shortage of N95 masks.

We previously discussed how the Vanderbilt University Hospital has repurposed its parking garage for a triage area for potential Covid-19 patients.  This is a picture of the same garage at a different time.

It was built by Hardaway construction.

It does raise an interesting question, though only somewhat related.  I had discussed the tents being set up throughout North and South Carolina hospitals as a triage area for potential patients with my daughter (an NP), and while she surmised they would be negative pressure like with their TB patients, I assert that the exhaust air (required to keep a negative pressure) has to go somewhere.

I discussed this with one of my state’s emergency planning officials.  This exhaust air is either (a) unfiltered, and thus very efficient at spreading the virus around, or (b) has HEPA filters and charcoal beds, which is unlikely because of availability.  Moreover, for the most part, such ad hoc installations will not have been tested and balanced by qualified engineers (I know something about testing HEPA filters and charcoal beds because I’ve done it before).  Qualified engineers aren’t a dime a dozen.  Activated charcoal is produced by charcoaling green coconut shells, and mainly comes from Sri Lanka.  From the standpoint of engineering, health and safety of the public, and industrial hygiene, this kind of epidemic just hasn’t been war-gamed well enough and America wasn’t prepared.  We’re not even close.

Consider your logistics train for the HEPA filters and activated charcoal.

UPDATE 3/21

Scientists are working hard to find therapeutics for Covid-19.

This is a picture of preparations for Covid-19 in a hospital garage in Tennessee.

This is an account inside a hospital in Louisiana.

As of Friday, Louisiana was reporting 479 confirmed cases of COVID-19, one of the highest numbers in the country. Ten people had died. The majority of cases are in New Orleans, which now has one confirmed case for every 1,000 residents. New Orleans had held Mardi Gras celebrations just two weeks before its first patient, with more than a million revelers on its streets.

I spoke to a respiratory therapist there, whose job is to ensure that patients are breathing well. He works in a medium-sized city hospital’s intensive care unit. (We are withholding his name and employer, as he fears retaliation.) Before the virus came to New Orleans, his days were pretty relaxed, nebulizing patients with asthma, adjusting oxygen tubes that run through the nose or, in the most severe cases, setting up and managing ventilators. His patients were usually older, with chronic health conditions and bad lungs.

Since last week, he’s been running ventilators for the sickest COVID-19 patients. Many are relatively young, in their 40s and 50s, and have minimal, if any, preexisting conditions in their charts. He is overwhelmed, stunned by the manifestation of the infection, both its speed and intensity. The ICU where he works has essentially become a coronavirus unit. He estimates that his hospital has admitted dozens of confirmed or presumptive coronavirus patients. About a third have ended up on ventilators.

“I have patients in their early 40s and, yeah, I was kind of shocked. I’m seeing people who look relatively healthy with a minimal health history, and they are completely wiped out, like they’ve been hit by a truck. This is knocking out what should be perfectly fit, healthy people. Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.”

[ … ]

“Typically with ARDS, the lungs become inflamed. It’s like inflammation anywhere: If you have a burn on your arm, the skin around it turns red from additional blood flow. The body is sending it additional nutrients to heal. The problem is, when that happens in your lungs, fluid and extra blood starts going to the lungs. Viruses can injure cells in the walls of the alveoli, so the fluid leaks into the alveoli. A telltale sign of ARDS in an X-ray is what’s called ‘ground glass opacity,’ like an old-fashioned ground glass privacy window in a shower. And lungs look that way because fluid is white on an X-ray, so the lung looks like white ground glass, or sometimes pure white, because the lung is filled with so much fluid, displacing where the air would normally be.”

This video comes from Italy.

This is the most recent curve fit.  The doubling time is currently 2.4 days using the same calculation given below.

UPDATE 3/20

President Trump is eyeing a two week national quarantine, with only grocery stores and pharmacies allowed to be open, all enforced by the National Guards of the respective states.  Here’s an interesting question.  I’ve pointed out before when the N.G. deploys to the border how difficult it is to arm the troops, with necessary rifle qualifications, lawyers having to write rules for the use of force (RUF)/ rules of engagement (ROE), etc., etc.  Arming orders have to be issued.  Rarely is that done stateside, not even for the Southern border.  Will N.G. troops be under arming orders, or will they have empty magazines?

Companies Teva and Mylan to jumpstart production of hydroxychloroquine to fight Coronavirus.  Opinion: You see the doctors with the FDA, NIH and CDC being pessimistic concerning the effectiveness because, in my opinion, not only are they being cautious, but because they aren’t the center of attention.  I’ve said before that the signal pathology of controllers is the desire to control others and be the center of attention.  It’s okay to have parlor talk about Covid-19.  It’s not okay with them for the peasants to actually know the names of the drugs and use them in common parlance, see the studies that have been done abroad, and conclude that the red tape and bureaucracy isn’t serving the interests of the American people.

The generation that wasn’t spanked.  I dropped by GNC today to purchase a male multivitamin/multimineral supplement, and the youngster behind the counter and I began discussing the current state of affairs.  In a remarkably unusual moment of candor for me when talking with someone I don’t know, I blurted out, “You know, the ones likely spreading this the worst are the college age kids who want to go out to bars and drink themselves into a stupor to ‘have fun,’ oblivious of the consequences to them or others.”

To my surprise, he responded, “Yep, that’s my generation – the generation that wasn’t spanked.”  In related news, 29% of American patients sick with Coronavirus are Millennials.  In other related news, out of control teens are intentionally coughing on grocery store produce in Harris Teeter stores and posting their videos on YouTube.

Also, recall that I pointed out the inconsistency of the FedGov complaining that citizens are buying N95 face masks stating on the one hand that they aren’t effective in stopping a virus, and on the other hand, complaining that the more we took, the less would be available for the health care system.  Well, this video session with an infectious disease expert explains it all.  According to him, the amount (or magnitude) of “inoculate” inhaled affects how sick a patient will become.  N95 masks do have something to do with that.  He even mentions an example of a health care worker forgetting to put on an N95 mask.  Begin about 10-12 minutes into his presentation.

Finally for tonight, I’ve updated the curve fit of confirmed Covid-19 cases in America with data through 2100 hours.  It’s a mess now, I strongly suspect, not because the actual doubling time has changed, but rather, because as I’ve mentioned before, there is a lead-lag function that I don’t know, and test availability and administration has changed.

Doubling time is at 2.42 days, although I’m not suggesting that the significant digits mean anything.

UPDATE 3/19

Californians ordered to stay home.  Also Politico.

Trump eyes grounding jets, halting stock trading, and ordering shelter in place.

The FDA approves Hydrochloroquine as prescribed by provider.

Look inside hospital in Italy.  Vimeo won’t allow me to embed the video but it’s worth watching if for no other reason than the shock value.

Here is an updated curve fit.  It’s rather a mess at this point, I surmise due to test availability and frequency of testing.

ORIGINAL POST

It seems to me like a good time to update my featured post.

Rather than posting little by little on this topic, I intend to roll this into a single post, and do my best to keep this post updated from time to time with related information.  I cannot devote my life to this analysis and I’m certainly not paid to do so.  As readers see fit, send new information, news reports, or your own analysis to my email account.  Revisit this post from time to time to see if there are any additions.  I’ll set the rules up front.

1] Updating this post won’t necessarily be a daily affair.

2] I can make no commitment as to how long I can keep this post updated.

3] Any additions will be made up front, not at the end of the original (or succeeding) updates

4] All analyses and information are correct to the best of my knowledge for the time it is written.  I make no warranty as to its correctness or usefulness beyond the minute it is posted.

5] My intent is to make perform clinical and unemotional analysis, not to engage in hyperbolic exaggeration.

So let’s begin.

I’ve been tracking the Johns Hopkins data for more than nine days now.  During this time I’ve had curve fits of the value for confirmed cases in America.  I have done nothing with world-wide confirmed cases.  The curve fit of confirmed cases versus tracking days follows.  Day 0 (zero) begins just above 600 confirmed cases, as that’s where I started tracking the data.

The curve fit, performed by EXCEL, is below.

y = 679.27e^0.2723x

Where y = Confirmed Cases, and x = Tracking Days.  The value of 679 is there because I didn’t begin tracking cases at time = 0.

I would rather use TableCurve-2D, and I’ll have to switch to another curve fit eventually because this one won’t last.  It won’t last because it will reach an upper asymptote and turn over.  There are those who won’t get it, there are those who get it, recover and are never tested, or perhaps virtually all of us will get it.  But the curve will turn over.

I won’t bother you with the mathematics, but in order to compute time to double the confirmed cases, this calculation is correct (using the value above).

ln(2) / 0.2723 = 2.55 Days

Doubling time is 2.55 days.  It’s been close to this value for as long as I’ve been tracking the data.  The curve fit has a very high correlation coefficient (R²) of 0.9951.  Doubtless, the Federal Government has this same kind of data and analysis.  This is nothing new to the CDC and state health departments.

This is why the Federal and State governments are so concerned about this.  Within a month more than two million Americans will have this virus unless we suppress the curve.  If we don’t have a vaccine within 30 days or thereabouts, there is no point and they may as well focus on therapeutic treatments.  Currently, the strategy employed by the government is [a] suppress the curve to prevent overwhelming the medical system, and [b] flood the country with cash to prevent a massive recession.

A word about mortality rate is in order.  You’ve heard values over the news with high variance, and it’s not because they are misleading you, either intentionally or unintentionally.  It’s because the value has a high variance.

It is INCORRECT to divide deaths by recovered cases and call that mortality rate.  That approach will massively over-estimate deaths.  Don’t do that.  It is likely also incorrect to divide deaths by confirmed cases because that will under-estimate mortality.  Don’t do that.

We don’t know at this time how long it takes for patients to fully shed this virus, and there is the further problem of the definition of recovery.  There is a lead-lag function that must go into this analysis to get a correct value, and you don’t have that.  Neither do I.

Moreover, there are many, many people who have already gotten this virus with no ill heath effect other than merely feeling crappy for a week, with full recovery.  They will never have been tested, and any future testing will be invalid.  This subset of data may very well be the largest subset in the larger set.

You will never know true mortality rate.  I will never know true mortality rate.  The only one who knows true mortality is God.  He won’t know it in the future.  He already knows it.

Performing epidemiological studies this way is not how any of this works.  There are thousands of studies that have been conducted on health effects of worker exposure to say, benzene or isocyanates, and those studies go into limits after being combined with other studies of the same thing, with uncertainty being combined using “pooled” variance.  What the CDC and state health departments is doing with Covid-19 is “flying by the seat of their pants.”

A word about the CDC.  They are the biggest disappointment in this whole ugly affair.  While they should have been studying epidemiology and infectious diseases, they were studying gun “violence,” racism and other irrelevant wastes of time.  This caught them by surprise.  They failed to see the effects of having America’s supply of pharmaceuticals rely almost exclusively on the very cause of this epidemic, China.  They acted too late to control it in America, they failed to ensure that there were enough medical supplies nation-wide (such as face masks) for an epidemic, and they’re simply holding on for the rough ride now, along with the rest of us.

A word about therapeutics.  My wife heard about a study over the national news (on one of the networks) where a controlled study had been conducted in France using the drug Hydrochloroquine.  40 out of 40 patients with Covid-19 underwent a full and complete recovery.

My wife stated that no one is talking about this.  That’s correct because they’re all taking pictures of toilet paper shelves in stores.  But I knew it.  This is the (non-peer reviewed) paper that describes the use of Hydrochloroquine as a therapeutic.  I mentioned this to my daughter and she said, “Hmm … that’s what we give for malaria.”  She’s right, and it’s cheap and effective for Covid-19.  There is also promise with the drug Remdesivir.

Now the question is this.  Has the FedGov stepped up production of this drug in America, or are we relying on China to sell it to us?  Ponder that question for a moment.  You are about to get the best witness and indication you’ve ever had in your lifetime whether the FedGov really cares about the health and safety of its citizens.  The mortality rate can be much lower than with the common flu, if only America’s resources are put to good use, and immediately so.

A word about root causes is in order.  I was taught in “Management Oversight and Risk Tree” analysis (MORT), that there is never one root cause.

China is one root cause.  Their failure to supply good information quickly was a problem from the beginning.  Their involvement in virtually everything that is manufactured and used in America is also a corollary to this.  Globalism is one large reason we are where we are with Covid-19.  The failure of the CDC to think proactively is another problem.  This was all war-gamed months ago and no one did anything about our vulnerability.  Finally, idiotic teens and college age kids who can’t stop going to bars and drinking themselves into a stupor is one reason why the spread of this virus won’t stop.

Again, there are a lot of root causes, every one of which was preventable.

A word on guns and ammunition.  I have plenty, but I felt like topping off my supply so I dropped by Academy Sports.  They have a limit of three boxes of ammunition per customer.  If you waited this late to find means of self defense, you waited too late.

As I said above, I’ll try to keep this post updated with relevant information.